Tyler Anne Wolfe

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

445 Shrewsbury Dr
Clarkston, MI 48348-3671

Phone

(248) 705-6541

NPI assigned

Oct 20, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Dermatology Group PCGroup PAC ID 8325338148, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Legacy Dermatology Group PC

  • Dermatology Physician
  • Waterford, MI
  • NPI 1588019053
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1497472443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 SHREWSBURY DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483671",
            "telephone_number": "248-705-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 SHREWSBURY DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483483671",
            "telephone_number": "248-705-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "TYLER",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Wisler, LLPC
• Kaitlin N Witherspoon
• Victoria L Wolak, OD
• Sheri Marie Wolcott, DPT
• Jaclyn Wolf, NP
• Lisa Ann Wolfgang, PTA
• Taylor Anne Woloszyk, BSN, RN
• Women'S Integrated Health Care, P.C.
• Womens OB/GYN and Bladder Solutions Center, P.C.
• Jared M Wood, L.L.P., PH.D.

• Physician Assistant in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.